Cirrhosis remains a major public health problem and disease-related complications were associated with nearly 40,000 deaths and more than 1.4 billion dollars spent on medical services in the United States. There is a great need to develop and identify methods of risk stratification and prognostication for patients with chronic liver disease. Hepatic fibrosis is the final common pathway for many different liver insults and is now known to be a dynamic process that is at least partially reversible. The diagnosis and quantification of fibrosis relies on liver biopsy, and liver biopsy is currently the gold standard for detecting and staging hepatic fibrosis. However, liver biopsy is an invasive procedure with significant risks, including hemorrhage, infection and visceral perforation. In addition, liver biopsy is a poor gold standard, because it is limited by interobserver variability in interpretation and sampling errors in 25-45% of cases.